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MONIT%3ING SYSTEM CERTIATION � CERTIFICATION / TEST DATE: December 28, 2009 Al. FACILITY A2. OWNER Name Fast Lane Lathrop Name Christina Gill Address 116 E. Roth Road, Lathrop, CA 95330 Address 111 Healdsburg Avenue, Healdsburg,CA 95448 Phone# 707-431-0541 Phone# 707-431.0541 Contact Christina Gill contact Christina Gill F. IN-TANK GAUGING I SIR EQUIPMENT: ■ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gaugung equipment is used to perform leak detection monitoring. Complete the following checklist: ■ Yes ❑ No" Has all input wiring been inspected for proper entry and termination,Including testing for ground faults? ■ Yes C3No` Were all tank gauging probes visually Inspected for damage and residue buildup? ■ Yes ❑ No' Was accuracy of system product level readings tested? ■ Yes ❑ No* Was accuracy of system water level readings tested? ■ Yes ❑ No' Were all probes reinstalled properly? ■ Yes ❑ No Were all Items on the equipment manufacturer's maintenance checklist completed? In Section H below, describe how and when these deficiencies were or will be corrected. G. LINE LEAK DETECTORS (LLD): ❑ Check this box if LLDs are not installed. Complete the following checklist: ■ Yes ❑ No For equipment start-up or annual equipment certification,was a leak simulated to verity LLD performance? ❑ NIA (check all that apply) Simulated leak rate: ■ 3 g.p.h.; ❑ 0.1 g.p.h.; ❑ 0.2 g.p.h. ❑ Yes ■ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ■ Yes ❑ No* Was the testing apparatus properly calibrated? ■ Yes ❑ No' For mechanical LLDs,does the LLD restrict product now if It detects a leak? ❑ NIA ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off If the LLD detects a leak? ■ NIA ❑ Yes ❑ No' For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled ■ NIA or disconnected? ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions ■ NIA or falls a test? ❑ Yes ❑ No' For electronic LLDs,have all accessible wiring connections been visually Inspected? ■ NIA ■ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In Section H below, describe how and when these deficiencies were or will be corrected. H. COMMENTS The Diesel MLLD was not tested due to tank being low on fuel.The product line would not build pressure. The MLLD will need to be retested when tank has been filled. 2006 Walton Engineering,Inc. Page 3 of 3